Medicaid-land

The Twilight Zone

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You are traveling through another dimension, a dimension not only of sight and sound, but of mind, a journey into a wondrous land where boundaries are that of imagination. That’s the sign post up ahead. Your next stop—Medicaid-land.

Pseudonyms are used for Medicaid and nursing home personnel.

The day after Christmas. My husband Lorin and I are wrung out from Christmas traveling. Yet we journey to Metropolitan Hospital in New York City, locus of the central Medicaid office, to obtain the essential piece of paper, the paper that would save us all—proof of my mother’s disenrollment from NY Medicaid. We moved her to a nursing home in New Jersey on September 6, the Actors Home, but she will not qualify for NJ Medicaid until this final document is obtained. We shall fight to the death for this document.

We arrive at the office. Lorin speaks to a bespectacled man in white thawb (gown) and kufi, who motions to his right. “She help you,” he mutters, almost unintelligibly.

The woman says, “This is the wrong office. You need to contact the office in Brooklyn that handles nursing home transfers.” She’s a bit gruff at first, but then she warms up, perhaps realizing our plight.

She writes down two phone numbers and an address.

Lorin says, “This is an urgent matter. We need the document in the next two weeks or we’ll have to start the enrollment process all over again.”

She says, “That shouldn’t be a problem.”

We thank her and return to the car.

The numbers have a 929 area code—the area code for another dimension. That’s not the Brooklyn area code, or any cell phone area code that we know of.

We make the calls in the car. I call the first 929 number.

“Hello, my mother was living in a nursing home in New York, and now . . .”

She cuts me off, “You have to call 718-557-1368.”

“But . . .”

Click.

Lorin says, “Call back.”

We put the cell phone on speaker and call the second number. A man answers.

“Hello, my mother-in-law moved from a nursing home in New York to a home in New Jersey and we need confirmation of her disenrollment so she can get New Jersey Medicaid,” Lorin says.

“You have to call this number: 718-557-1368,” the man says.

“Okay, but we need confirmation right away. This is time-sensitive,” Lorin says.

“I understand, but we can’t help you here. You have to call this number. They can give you what you need,” the man says.

“Okay. If we don’t get what we need from them, we may be stopping by your office,” Lorin says.

“We don’t see people here,” he says.

What kind of place is this, Area Code 929?

I call the 718 number, and speak to Miss S.

“What’s your mother’s social security number?” she says.

I give it to her.

“We don’t have a discharge notice for her from the other nursing home,” she says. “You’ll need to contact them to obtain the form.”

“Okay, what form do I need, and where does it go?”

“Tell them you need MAP 259F. They know what it is. They must complete the form, fax it to us, and indicate on the form where the confirmation notice should go, which would be your home address or the nursing home in New Jersey.”

“Okay, but New Jersey Medicaid needs this form in 2 weeks. Do you think that can be done?”

“That shouldn’t be a problem.”

“Thank you for your help. Happy Holidays.”

“Same to you.”

I call Silvia, the social worker at the old nursing home, and get voicemail. Lorin and I decide to go in person to get this taken care of. This form should have been sent right after Mom was discharged—almost 4 months ago. We are seething. I feel nauseous.

Lorin says, “No more Mr. Nice Guy.”

We drive to the nursing home in the Bronx, and wait for Marlene, the administrator, to speak with us.

She appears in the lobby, looking like a beaten dog.

“Hi, Marlene, Happy Holidays,” I say.

“What’s up?” she says, expressionless.

We explain the situation.

“Come into my office,” she says. “Silvia’s not in today, so this will have to get done on Monday.”

“Okay,” I say.

Lorin explains how urgently we need the document. “Why wasn’t the discharge notice sent back in September?” he says.

“I have no idea. Human error, I suppose. Nobody’s perfect,” Marlene says.

It’s hard to get angry at someone who looks like they’re on suicide watch, so we don’t.

“What’s the name of the form you need?”

“MAP 259F,” I say.

She locates it on her computer and prints it out.

“Write Silvia a note saying where you need the confirmation sent, and I’ll put it on her desk with the form.”

She hands me a slip of paper the size of a check, and I run out of space.

“May I have a larger piece of paper?” I ask, and she hands me a ruled notepad.

“May I sit here?” I ask, pointing to a chair piled high with boxes.

“Sure.”

I place the boxes on the floor and start to write a note. I ask Lorin to check the note, and he asks to re-write it: I’ve missed some pertinent facts. Guess I’m overly tired.

We hand the completed note to Marlene.

“Make sure you can read this,” Lorin says. She reads it.

“I’ll make sure Silvia sees this on Monday. Lorna is on vacation for two weeks starting Monday, so Silvia will be on her own which means she has an extra workload. She’ll do her best.”

“Okay, but we need this form as soon as possible,” Lorin says.

“I understand. She’ll fax you and the nursing home a confirmation on Monday after she faxes it to Medicaid. She won’t have to time to send emails to all these people,” she says, with tired disgust.

“That’s okay. We included the emails just in case,” I say. “Thanks for your help, Marlene, and Happy New Year.”

“Okay,” she says, and we exit the premises.

I send an update to the social worker at the Actors Home, letting her know what has transpired.

All we can do now is hope and pray that the MAP 259F will be completed and processed in due time. The Paperwork is all that matters in Medicaid-land.

 

22 thoughts on “Medicaid-land

  1. It is absolutely disgusting that health care in this country is so messed up, and so entangled in bureaucratic red tape. You have my sympathies. I really hope that everything works out.

    I had to get an MRI a couple of months ago, and it was a nightmare getting approval from the insurance company. First they issued an approval for the wrong test, which I only found out when I showed up at the medical center to have the MRI done. I had no idea it was the wrong procedure; I am not a doctor or medical technician, so I certainly could not read the approval and understand the terminology was referring to a different test. I had to call my doctor’s office the next day to explain what happened. According to the doctor’s assistant, she spent literally half the day on the phone with different people at the ins co getting everything straightened out. I was finally able to go back to the med center a few weeks later and get the MRI done. Believe me, I let the assistant know how grateful I was for all her help in fixing the ins co’s mess.

    Liked by 2 people

  2. That’s awful, Ben. You have to be so pro-active these days. It’s amazing how much slips through the cracks. As my husband and I often say to each other, if we performed our jobs the way some of these bureaucrats did, we’d have been fired long ago.

    Liked by 1 person

  3. Reading this just gave me a panic attack. Having worked as a social worker in a large hospital, I know how time sensitive the forms for Medicaid, Medicare, disability and discharging and transferring patients are….and there seems to be no accountability here. It’s like blowing on a dandelion and hoping the seeds fall in the right place. Our benefits programs are dismally run, and it’s just criminal that those who are most vulnerable in our society are at the mercy of this crippled dinosaur of a system.

    Liked by 2 people

    • You hit the nail on the head, Nancy — no accountability. The Actors Home was told we were to go to the Medicaid office at Metropolitan Hospital, yet when we arrived there we were told otherwise, and on it goes. Having dealt with Medicaid many times before on behalf of my mom, I was not at all surprised. The Kafka novel continues.

      Liked by 1 person

  4. If not a kafka-esque nightmare, it’s your own “who’s on first,” sorta…I feel for you! Also, don’t rely on fax. Every fax I ever sent did not get received by the party that was supposed to. Back up with registered or certified mail. And this is all fodder for another performance piece… you know you weave straw into gold, Erica!

    Liked by 1 person

  5. More excellent writing on this topic, Erica. I love the side bars about exhaustion. So very Kafka – makes me think of your show. Wishing you luck. Holidays make people think they don’t have to do anything within a deadline. xoxo

    Liked by 1 person

  6. Ugh. I grew up in NYC and as a tween and teen handled all the red tape for my parents who didn’t speak English well. I wanted to pull my hair out reading this. It’s so NY (and Jersey, I guess!). Your patience is amazing. Hope things work out – on and off the blog.

    Xx
    Diana

    Liked by 1 person

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